The BBC, Daily Mail, Independent and New Statesman have reported criticism of the coalition government for continuing the summary care records scheme.

When in opposition the Conservatives hadn’t said they would cancel summary care records. But they’d criticised the way the DH and NHS Connecting for Health managed the scheme, particularly the barriers they put in the way of patients who wanted to opt out. The Tories had also criticised the database state, including summary care records.

“It’sas though Connecting for Health and the strategic health authorities aretrying to reach a critical mass [of letters sent out to patients onSCRs] , to ensure it would be difficult for the scheme not to continue.”

TheBBC, and other parts of the media, quoted Alex Deane of Big BrotherWatch who said:

“The government wants us to believe that they’reserious about privacy and civil liberties. This is their first test andthey’ve failed it. The summary care record is an unnecessary andintrusive piece of bureaucracy.”

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Ian Watmore, the former government CIO, said that failing projects should be cancelled early and cheaply. It sounds easy but what is a failing project?

Summary Care Records has, in my view, so many flaws that it should be independently reviewed before it continues.

It's unknown whether the data is accurate enough to be trusted by doctors. Should data be proven to be accurate before an upload takes place?

Proper data cleansing would make the SCR more trustworthy to clinicians but it would take much longer to upload records, which would discourage doctors from using the system in the meantime, as they'd have a low chance of finding their patients on the system.

It's unknown also:

- what will go into the SCR

- whether it's right that patients should be opted in if they don't take the trouble to opt out

- whether the rare incidents of malicious access will tighten security to the point where the system is boycotted as too cumbersome

- how the system will work in child-protection context (ie will parents opt out children who are at risk?)

- whether hospital doctors will want to change their working habits to access SCRs.

All these problems will probably not be flagged clearly to new ministers. Briefings to ministers I have read in the past have over-emphasised the positive and buried the negative in complexity and coded language.

It's a masterstroke of Labour ministers, the DH and CfH to have given incentives to PCTs to send out leaflets by April 2010, if only because it greatly increases the "sunk" costs of the SCR - the costs that can't be recovered should the scheme be cancelled.

Add the costs of the leaflets being sent out to BT's sunk costs in building the SCR "spine", plus compensation to BT for loss of profits in not supporting the SCR and DH can build a good case for not cancelling the SCR.

It's not for me to say that the SCR should be cancelled. I don't think it should carry on, though, without answers to the flaws highlighted above.

Meanwhile there's a danger the project will be measured as a success not on its value to doctors or patients but on the amount of uploads, accesses, and number of leaflets sent out